Previous Surgery and Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea

Eric J. Kezirian*, Clemens Heiser, Armin Steffen, Maurits Boon, Benedikt Hofauer, Karl Doghramji, Joachim T. Maurer, J. Ulrich Sommer, Ryan J. Soose, Richard Schwab, Erica Thaler, Kirk Withrow, Alan Kominsky, Christopher G. Larsen, Jennifer Hsia, Reena Mehra, Tina Waters, Kingman Strohl

*Corresponding author for this work
5 Citations (Scopus)

Abstract

Objective: To examine whether previous palate or hypopharyngeal surgery was associated with efficacy of treatment of obstructive sleep apnea with hypoglossal nerve stimulation. Study Design: Cohort (retrospective and prospective). Setting: Eleven academic medical centers. Subjects and Methods: Adults treated with hypoglossal nerve stimulation were enrolled in the ADHERE Registry. Outcomes were defined by the apnea-hypopnea index (AHI), in 3 ways: change in the AHI and 2 definitions of therapy response requiring ≥50% reduction in the AHI to a level <20 events/h (Response20) or 15 events/h (Response15). Previous palate and hypopharyngeal (tongue, epiglottis, or maxillofacial) procedures were documented. Linear and logistic regression examined the association between previous palate or hypopharyngeal surgery and outcomes, with adjustment for age, sex, and body mass index. Results: The majority (73%, 217 of 299) had no previous palate or hypopharyngeal surgery, while 25% and 9% had previous palate or hypopharyngeal surgery, respectively, including 6% with previous palate and hypopharyngeal surgery. Baseline AHI (36.0 ± 15.6 events/h) decreased to 12.0 ± 13.3 at therapy titration (P <.001) and 11.4 ± 12.6 at final follow-up (P <.001). Any previous surgery, previous palate surgery, and previous hypopharyngeal surgery were not clearly associated with treatment response; for example, any previous surgery was associated with a 0.69 (95% CI: 0.37, 1.27) odds of response (Response20 measure) at therapy titration and a 0.55 (95% CI: 0.22, 1.34) odds of response (Response20 measure) at final follow-up. Conclusion: Previous upper airway surgery was not clearly associated with efficacy of hypoglossal nerve stimulation.

Original languageEnglish
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume161
Issue number5
Pages (from-to)897-903
Number of pages7
ISSN0194-5998
DOIs
Publication statusPublished - 01.11.2019

Research Areas and Centers

  • Research Area: Luebeck Integrated Oncology Network (LION)

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